There are a number of symptoms that are used to help diagnose depression. Looking at all instances of depression that can be confirmed (i.e. psychological help is obtained or a suicide occurs from depression-related circumstances), a one-author report states that women have a higher rate of major depression than men, but looking at individual symptoms, the gender divide intensifies in some areas, disappears in some, and reverses in others. While women have a greater proportion of somatic symptoms, such as appetite, sleep disturbances and fatigue accompanied by pain and anxiety, than men, the gender difference is much smaller in other aspects of depression. Female respondents report twice the prevalence of somatic symptoms as male (2.8% vs. 1.4%) versus depression not associated with somatic symptoms (2.3% vs. 1.7%). Depression with somatic symptoms is highly likely to also have an anxiety disorder (31.4% vs. 22.9%), to have pain (60% vs. 48%), and to have chronic depression (49.2% vs. 36.8%). Men with depression with somatic symptoms were more likely than those without to have pain (48.9% vs. 28.6%) but were not more likely to have an anxiety disorder (39.3% vs. 31.9%) or chronic dysphoria (37.8% vs. 33.3%). Instances of suicide in men is much greater than in women. In a report by Lund University in Sweden and Stanford University, it was shown that men commit suicide at a rate almost three times that of women in Sweden, and the Centers for Disease Control and Prevention and National Center for Injury Prevention and Control report that the rate in the US is almost four times as many males as females.[26] However, women have higher rates of suicide ideation and attempts. The difference is attributed to men choosing more effective methods resulting in the higher rate of success.